摘要
目的：探讨透析用导管相关性感染的易感因素。方法：按导管相关性感染的诊断标准，将本院2000年1月～2004年12月间 120例颈内静脉穿刺置管的尿毒症血液透析患者分为感染组(30例)和非感染组(90例)，置管前检测血红蛋白(Hb)、外周血淋巴细胞 计数(LY)、血清免疫球蛋白(IgG、IgA)、血清补体(C_3) 、血清白蛋白(ALB)、C 反应蛋白(CRP)、内生肌酐清除率(Ccr)等指标，并收集有 无合并感染等情况。采用t检验或卡方检验及 Spearman 等级相关分析等分析透析用导管相关性感染的易感因素。结果：(1) 感染组 的糖尿病肾病比例明显高于非感染组(66． 7%vs 3． 3%，P＜0． 05) ；(2) 感染组合并其他部位感染的比例显著高于比非感染组(18/30 vs 27/9H0，P＜0． 005) ；(3) 与非感染组相比，感染组 Hb、IgG、LY、ALB 水平均明显低下(P＜0． 05) ，CRP 水平明显增高(P＜0． 001) ；(4) Spearman 相关分析显示，感染与 Hb(r_s=-0． 308，P=0． 014) 、IgG(r_s=-0． 248，P=0． 008) 、LY(r_s=-0． 452，P=0． 009) 、ALB(r_s=- 0． 330，P=0． 000) 水平呈显著负相关，而与 CRP 水平呈显著正相关(r_s=0． 474，P=0． 000) 。结论：原发疾病为糖尿病肾病、存在其他部位 感染、外周血淋巴细胞减少、血清免疫球蛋白 IgG 低下、低蛋白血症、严重贫血，可能为颈内静脉透析用导管相关性感染的易感因素。
Objective： To investigate the suspected risk factors of hemodialysis catheter related infections. Methods： According to the diagnostic criterion of catheter-related infections, we divided 120 uremic patients with internal jugular venous catheter insertion for hemodialysis into the infected group（n = 30） and the uninfected group（n = 90）. Before insertion, we examined their hemoglobin （Hb）, peripheral blood lymphocyte count （LY）, serum complement 3 （C3）, albumin （ALB）, plasma C-reactive protein （CRP）, endogenous creatinine clearance rate （Ccr）, and other infectious disease status. T Test, Chi-Square Test and Spearman＇s Rank Correlation Analysis were used. Results： （1）The percentage of patients with diabetes mellitus in the infected group was significantly higher than that of uninfected group（66.7% vs 3.3%, P〈0.05）. （2）The proportion of patients with other infectious disease in the infected group was also significantly higher than that of uninfected group（ 18/30 vs 27/90, P〈 0. 005）. （3）Compared with the uninfected group, the infected group had lower levels of Hb, IgG, LY, ALB（P〈0.05）and higher level of CRP （P〈0. 001 ）. （4）There were noticeable negative correlation between catheter-related infections and Hb（rs = -0. 308,P = 0. 014）, IgG（rs = - 0. 248, P = 0. 008）, LY（ rs = - 0. 452, P = 0. 009） and ALB（ rs = - 0. 330, P = 0. 000）, respectively. While there was distinguished positive correlation between catheter-related infections and CRP（rs = 0. 474,P= 0. 000）. Conclusion：The suspected factors of hemodialysis eatheter-related infections may be diabetic nephropathy, complicating with other infeetious disease, low peripheral blood lymphocyte count, low serum IgG level, hypoproteinemia and severe anemia
出处
《中国临床医学》
北大核心
2005年第5期839-841,共3页
Chinese Journal of Clinical Medicine
关键词
导管相关性感染
易感因素
血液透析
Catheter-related infections
Suspected factors
Hemodialysis
